Hydrops foetalis and chylothorax associated with superior caval vein obstruction and resolution following balloon dilatation

Abstract

A female infant (33 weeks' gestation) was delivered by emergency caesarean section because of hydrops foetalis. No cause was identified initially; haemoglobin, liver and renal functions were normal and there was no evidence of sepsis or significant myocardial dysfunction or arrhythmia. There was initial improvement with conventional management but bilateral pleural effusions persisted, which became overtly chylous after institution of enteral formula feeds on day 4. At 5 weeks of age, an obstruction at the superior caval vein/right atrial junction was confirmed at angiography and dilated with resolution of all remaining oedema and fluid collections. Repeat venography at 9 months of age showed a normal superior caval vein and she remains well at 15 months.